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The patient is presenting with a persistent cough and is expectorating green sputum leading to the diagnosis of acute bronchitis. McCance & Huether (2019) define acute bronchitis as an inflammation or infection of the bronchi or airway caused by a virus. The patient is coughing as a result of a protective reflex from the vagus nerve. Coughing allows the individual to expectorate her secretions from the lower airways (McCance & Huether, 2019). The feeling of gagging and dry heaves is caused by the patients deep cough with the goal of expectorating the tenacious, thick sputum. Viral infections, allergens, or pollutants might trigger an inflammatory response in the bronchi resulting in acute bronchitis. When the bronchial wall is inflamed, mucosal thickening and epithelial-cell desquamation occur (Smith et al., 2020). The inflammation and infection on the bronchi create secretions causing irritation leading to a strong cough.

     According to this case, Lou most likely developed acute bronchitis as a result of a viral infection as she does not have a medical history or history of smoking. Common clinical manifestations of acute bronchitis include coughing, expectoration, chest pain, shortness of breath, and wheezing from baseline versus after 7 days of treatment (Nowicky & Murray, 2020). Pulmonary environmental toxins or allergens might play role in Lous condition, such as nitrous oxides, methane, arsenic, lead, cadmium, and air pollution. Two patient factors that heavily influence the diagnosis of acute bronchitis are age and behavior. Patients over the age of 65 and children younger than two years are at risk of acquiring infections (Nowicky & Murray, 2020). Common pathogens include influenza virus A and B, parainfluenza, and rhinovirus. Implementing infection precautions and getting routine vaccinations are preventable measures vulnerable populations can engage in.  Furthermore, behaviors like smoking can develop into chronic obstructive pulmonary disease (COPD).  Individuals with COPD are more likely to develop chronic bronchitis (Nowicky & Murray, 2020). All in all, Lou’s acute bronchitis can be managed with antibiotics and cough expectorants.